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Why I voted in favour of alternative medicine
Posted: 23 May 2009 02:11 PM   [ Ignore ]   [ # 16 ]
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VYAZMA - 23 May 2009 02:03 PM
Jules - 23 May 2009 01:54 PM

I dislike the term alternative medicine because it’s not medicine at all. What sounds better… quack pseudo-remedies? I like that one.  wink

What does it say in the dictionary under “Medicine”?

Furthermore—who uses the term alternative medicine anyways? Mostly the scrutinizers!! The average citizen doesn’t turn to their friend and say: ” I gotta go down to the drugstore and get my alternative medicines”!!

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Posted: 23 May 2009 02:53 PM   [ Ignore ]   [ # 17 ]
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VYAZMA - 23 May 2009 02:03 PM
Jules - 23 May 2009 01:54 PM

I dislike the term alternative medicine because it’s not medicine at all. What sounds better… quack pseudo-remedies? I like that one.  wink

What does it say in the dictionary under “Medicine”?

“Any substance or substances used in treating disease.”

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Posted: 23 May 2009 03:34 PM   [ Ignore ]   [ # 18 ]
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VYAZMA - 23 May 2009 01:58 PM

Back in 19…what was it? 62,64, how succesful was Congress in passing legislation at controlling the relationship between doctors and the medical supply, technology and pharmaceutical companies? How about the consolidation of hospitals nowadays and the entrance of these concerns on the Stock Market?
Are doctors allowed to own pharmacies still? Or just the stock of pharmacy companies?
Again on this Forum we see various specialists, entrenched specialists, who still are beholden to the idea that they know about what’s good for people(and are probably right!!)yet are vastly outnumbered by the sheer will of the people.
These dynamics are covered above. And, if we are to believe the stump speeches, a change is coming to this particular entrenched industry, that is going to modify some of these Hippocratic Audacities.
Prime example: what person hasn’t seen the pull and tug going on for years in this arena, and has the consumer/patient benefited?

VYAZMA, you’ve gone on these rants about the medical industry before. You sound a lot like my father’s 70 year old tennis buddies. Many of them believe in these conspiracy theories about doctors and the pharmaceutical companies. Unfortunately there is a grain of truth to some of it but the fact is that you old timers are recycling a lot of old news that no longer applies. For the 20 years or so that I have been in practice it has been illegal for pharmaceutical companies to give anything of substantial value to physicians ( they had outlawed vacations and the sort before I ever went into practice). Recently they even outlawed anything as simple as a pen.

As far as owning pharmacies, I don’t know the law, but I also have never known a physician who owned one. It would be a dumb idea anyway. Its unlikely a physician could prescribe enough ‘extra’ medication for his patients ( assuming he was that unethical) to make a significant difference in the pharmacy’s profits. Its even more insane to think that owning stock in a pharmaceutical company would change a doctors prescribing habits since his contribution t the overall profits of the company would be undetectably small. Physicians do sometimes own pharmaceutical stocks but they do so because its what they know ( or think they know). AS Warren Buffet is fond of saying, “Only invest in things you understand”.

As far as knowing whats best for people…Well Duh. Physicians have spent the better part of their lives studying medicine and diseases. I’m all for including my patients in the process, but what I find amazing ( and offensive) is that people now think all they need is an internet connection, some vague understanding of pseudoscience, and a friend at the gym or the local vitamin shop to put their opinion on the same level as a trained health care professional.

[ Edited: 23 May 2009 04:19 PM by macgyver ]
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Posted: 23 May 2009 04:27 PM   [ Ignore ]   [ # 19 ]
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Jules - 23 May 2009 02:53 PM
VYAZMA - 23 May 2009 02:03 PM
Jules - 23 May 2009 01:54 PM

I dislike the term alternative medicine because it’s not medicine at all. What sounds better… quack pseudo-remedies? I like that one.  wink

What does it say in the dictionary under “Medicine”?

“Any substance or substances used in treating disease.”

On a side note, it’s interesting that the definition of medicine is a substance to treat disease while the alternative medicines on the market have that FDA statement on them saying “These have not been evaluated by the FDA. This product is not intended to treat, cure, diagnose or prevent any disease.”

But that’s just me making smart-mouth jokes about the name/label. What truly upsets me is hearing of parents withholding 90% effective cancer treatment for their kid in favor of “blood cleansing herbs” or parents not giving their children with asthma inhalers - instead putting magnets on their chest. Even people who suggest that children with appendicitis be given a hot poultice instead of taken to the emergency room! And the people who promote these products to ignorant people, claiming that they truly work, I feel they are at least partially responsible for promoting these dangerous scams to make money.

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Some people can read War and Peace and come away thinking it’s a simple adventure story. Others can read the ingredients on a chewing gum wrapper and unlock the secrets of the universe.    - Lex Luthor

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Posted: 23 May 2009 04:33 PM   [ Ignore ]   [ # 20 ]
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Mac, I believe Vyazma is younger than you are.  While my opinions are more in concert with yours, I think his comments have a fair amount more than “a grain of truth”.  Funny that you should mention the illegality of giving a pen, because it seems that about half the time when I sign in at a doctor’s office, I’m using a pen with some pharmaceutical logo on it.  And every time I pull into the parking lot of a medical building, there are sales people unloading their little rolling goody kits and going to the various offices with stacks of their pills and other little perqs, pads, calendars, pens, candies, etc. 

Yes, I trust my doctors, but that doesn’t mean I stop my own thinking.  I ask questions and occasionally they change their thinking based on the answers they give.  Like my urologist who was worried when a cat scan showed a mass on my kidney.  He gave me a reference to an oncologist, however, I asked if he could check the results against the cat scan I had ten years ago because of kidney stones.  He did, and surprise.  It was thare then and there was no change. 

And, I’ve had no compuntion against changing doctors in the past when I realised they were incompetent or unwilling to treat me as a rational human being rather than as a child.  And, yes, some doctors, no matter how much of their lives they’ve spent studying medicine and diseases are incomptent. 

Occam

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Posted: 23 May 2009 05:06 PM   [ Ignore ]   [ # 21 ]
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I’m basically in concert with you guys as well. Mac- I’m sure you read that I don’t advocate the more “quackily” type treatments. I certainly would oppose guardians of children restricting their access to Professionals. Come on guys, don’t use that as leverage. I’m all about science and facts. My diatribe started as an attempt to realize the reason for CAM’s or Homeopathic meds.
They are prolific, and there is a reason for it. It isn’t based on superstition. It’s a complicated cause that has it’s roots in many things such as tradition, economics, political system etc.
Importantly we must grade the varying forms of alt.meds.Obviuosly quackery is wrong.(I remember reading about it in health class, they taught us it was illegal, hence I was surprised to see it’s recurrence in the last 15 or so years-magnetic bracelets)
However, home remedies, herbs, massages etc..no matter how inert are not going to go away.
There is also a whole industry of quackery meant to play on the social/pyschological factors-such as Hydroxycut, dexatrim, and maybe even Botox.
My whole “thing’ about this is the desire of people. The peoples will. What the people want, the people make.
From this point in the conversation it becomes the same as discussing how to ween people off of religion. It isn’t easy.
Originally GdB offered up some points on the inclusion of CAM’s as a surrogate for more costly treatments within a State-run Health System. I think, as well as others, that there is some legitamacy to this. I’m not saying treat leukemia with Bee Pollen. We all know there are a plethora of different patients and patient needs.

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Posted: 23 May 2009 05:21 PM   [ Ignore ]   [ # 22 ]
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VYAZMA - 23 May 2009 02:03 PM

What does it say in the dictionary under “Medicine”?

*sigh* I need to place this where I can paste it in instead of rewriting it into every thread where it comes up.
THE DICTIONARY DEFINES WORDS AS THEY ARE BEING USED IN COMMON USAGE. It is not the same as a math problem which says 1+1+2.
DEFINITION FOLLOWS USAGE IN THE DICTIONARY. THE DEFINITIONS ARE SUBJECT TO CHANGE AS USAGE CHANGES.
If idiots equate quackery with medicine in the dictionary through usage—-it doesn’t magically change it from being quackery (abracadabra)—it is STILL quackery masquerading as medicine.

Okay, suppose the quack treatment placates the hypochondriac that didn’t really need to be seen anyway. What about all of the people who will use the quackery for serious illnesses and end up getting worse than they would have been had they pursued proved medicine in the first place and eat up medical dollars, or just plain die from something that would have been easily treated? To put quackery on the same level as proved science based medicine is to take away the ability of the lay person to discern what is real, and what is not real medicine. When I go to the doctor I want science treating me, NOT superstition!
If you haven’t noticed I am in total agreement with the docs!!!

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Posted: 23 May 2009 11:00 PM   [ Ignore ]   [ # 23 ]
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Occam - 23 May 2009 04:33 PM

And, I’ve had no compuntion against changing doctors in the past when I realised they were incompetent or unwilling to treat me as a rational human being rather than as a child.  And, yes, some doctors, no matter how much of their lives they’ve spent studying medicine and diseases are incomptent. 

Occam

It’s like the old joke.

You know what they call someone who graduates last in their medical class?

Doctor.

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Posted: 24 May 2009 12:31 AM   [ Ignore ]   [ # 24 ]
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Herf - 23 May 2009 11:00 PM
Occam - 23 May 2009 04:33 PM

And, I’ve had no compuntion against changing doctors in the past when I realised they were incompetent or unwilling to treat me as a rational human being rather than as a child.  And, yes, some doctors, no matter how much of their lives they’ve spent studying medicine and diseases are incomptent. 

Occam

It’s like the old joke.

You know what they call someone who graduates last in their medical class?

Doctor.

Doctors are no different than mechanics or hairdressers in that there are the good ones, the great ones and the bad ones! It’s unrealistic to think otherwise.
Graduating last in their class is not necessarily an indication that this is going to be a bad doctor. I’ve known plenty of bad doctors who graduated near the top of their class at top notch schools. Some learn better during their residency and quickly become very good doctors there. I am lucky in that I have not had a doctor in 25 years that I did not know through his or her residency program. I learned not to judge them by what they did in medical school, but in how they put the knowledge into practice which is where it counts. I’ve worked with a neurosurgeon who had the bedside manner of a lump of coal, but he could work miracles in the operating room, and was also hard on the nurses that took care of his patients, but they had wonderful outcomes, I’ve told patients that have complained that they have a point but I would rather have an obnoxious extremely talented surgeon cutting on me than a compassionate incompetent (although a very famous surgeon had a son who was a surgeon that was both obnoxious and incompetent!)!  I’ve also known idiot nurses who got very high scores on their exams that were stupid at the bedside (and would constantly remind me of their scores and grades hmmm , they no longer publish the scores—it is just pass or fail.

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Posted: 24 May 2009 12:35 AM   [ Ignore ]   [ # 25 ]
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Of course what you say is true but hey, it’s just a joke. smile

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Posted: 24 May 2009 12:37 AM   [ Ignore ]   [ # 26 ]
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Herf - 24 May 2009 12:35 AM

Of course what you say is true but hey, it’s just a joke. smile

wink

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Posted: 24 May 2009 04:24 AM   [ Ignore ]   [ # 27 ]
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I would like to react on a few points:

Of course the aim of pharmaceutical industry is profit. And it goes disputable ways sometimes:
- medicals proven to be bad, and forbidden in one country, are still sold in others
- pharmaceutical industry spend more money on marketing than on R&D
- it ‘invents’ new diseases, to sell their exactly fitting medicine
- antibiotics are used for aims that they are not really meant for e.g. in the bioindustry. If antibiotics were used only for dangerous bacterial diseases, we would not have such a problem with resistance. But the industry wants to sell!

It is obvious that one can earn a lot of money in medical practice. A lot of doctors are rich. That’s OK to me when they are responsible and good. But a lot of not so good doctors want to be rich too. (BTW, one way to look at alternative healers is that they are jealous, and also want part of the cake. Just a few weekend courses of X, and you can take the money from your patient’s pockets… )

Modern medicine surely is science based, but not only science based: it is also experience based, in ways that do not stand scientific scrutiny. One example is many forms of ‘off lable use’ of medicine. I was perplexed when I read recently that double blind experiments are not that old (from the fifties on), and that still a lot of medicine was never really tested double blind. I was even more astonished that some operations turned out to be placebo operations (certain kind of knee operations).

Only slowly doctors and hospitals are going to treat medical errors in the right way: confess that they made the error, and investigate why it happened to learn to avoid such errors in the future.

Is it a miracle that some people have a deep distrust against modern medicine? Isn’t it clear that such medical practices create a market for ‘alternatives’?

Again, I do not discuss the real insight (and eventually the corrective power) of medical science. I am discussing the way it is used. The question is: how do we get the quack believers on board? What do we have to change in modern medical practice to get that done? I am just sure that yelling we are right (even that we know we are right), or forbidding alternatives isn’t the right way.

And Doug, I do not want democratic processes to decide what is true. But how we deal with scientific results is another question. As soon as power is involved (e.g. FDA) one cannot be sure if decisions are made on basis of truth only. It needs very high moral standards for members of such organisations, and to me it is clear that the pharmaceutical industry does not has these standards.

I do not say I have a better alternative. But closing our eyes for these problems is a bad strategy.

GdB

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Posted: 24 May 2009 06:21 AM   [ Ignore ]   [ # 28 ]
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GdB - 24 May 2009 04:24 AM

Of course the aim of pharmaceutical industry is profit. And it goes disputable ways sometimes:
- medicals proven to be bad, and forbidden in one country, are still sold in others
- pharmaceutical industry spend more money on marketing than on R&D
- it ‘invents’ new diseases, to sell their exactly fitting medicine
- antibiotics are used for aims that they are not really meant for e.g. in the bioindustry. If antibiotics were used only for dangerous bacterial diseases, we would not have such a problem with resistance. But the industry wants to sell!

Agreed on your examples. These show that one aim of the pharma industry is profit. However, that is not their only aim. Their other aim, clearly, is to cure disease.

As well, the aim of the “alternative medicine” (quack) industry is profit. The difference is that they have no intention of actually curing anything.

GdB - 24 May 2009 04:24 AM

Again, I do not discuss the real insight (and eventually the corrective power) of medical science. I am discussing the way it is used. The question is: how do we get the quack believers on board? What do we have to change in modern medical practice to get that done? I am just sure that yelling we are right (even that we know we are right), or forbidding alternatives isn’t the right way.

And Doug, I do not want democratic processes to decide what is true. But how we deal with scientific results is another question. As soon as power is involved (e.g. FDA) one cannot be sure if decisions are made on basis of truth only. It needs very high moral standards for members of such organisations, and to me it is clear that the pharmaceutical industry does not has these standards.

I do not say I have a better alternative. But closing our eyes for these problems is a bad strategy.

It seems to me that your previous example, however, would be counterproductive for helping the issues you raise. As I say, having the public health service fund quack remedies simply legitimizes them in the eyes of the public. That is precisely what it should not be doing.

As you say, “as soon as power is involved one cannot be sure if decisions are made on the basis of truth only.” And your proposed solution is to ensure that at least one class of decisions is explicitly not made on the basis of truth, but on the basis of falsehoods? That cannot be right. Certainly, I am sure the FDA has made its share of errors. However the way to correct those errors is not to introduce new ones.

As for getting quack believers on board, one issue that has been discussed time and again is that much of modern medicine is too cold and impersonal. Many people do not feel that their doctors care about them as individuals, mostly because those doctors are overworked and—yes—underpaid. (The medical profession is nowhere near as remunerative now as it once was). That is particularly true of nurses, who are most likely the people one will spend the most time with. Some of this is simply unavoidable. Everyone is trying to cut medical costs, and that will not change.

Some of the embrace of quackery comes from the apparently genetic tendency of humans to believe in woo—the power of prayer, etc. I don’t believe there is anything that modern medicine alone can do to combat that form of quackery. It’s too big a problem. I am very interested in ways you think that beliefs in woo can be countered, however I don’t think that public funding of woo is the right strategy.

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Posted: 24 May 2009 06:22 AM   [ Ignore ]   [ # 29 ]
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Off label use is NOT usually a BAD thing. It usually happens when doctors and clincians notice that a drug prescribed for one thing has unintended and unexpected (which is not to mean bad) side effects that may have nothing to do with what is was prescribed for. The most famous examples I can think of are Viagra and Rogaine. As far as prescribing antibiotics for minor illnesses. The bigger problem is appropriate prescribing when patient INSIST on antibiotics for viral illnesses and the doctors give in to overly annoying patients to get rid of them, but also a bigger problem is the patient that doesn’t FINISH the prescribed course and exacerbates the creation of ‘superbugs’. The other problem is insurance. Would YOU be willing to risk YOUR license and lively hood by making the call that an illness that the prudent doctor would treat with antibiotics will get better without it. Another problem with making the decision about where or not you treat, you are not always treating for mortality, you are sometimes treating to prevent disability and morbidity.Sometimes, it’s just because the patient needs to go back to work and earn a living and doesn’t have the luxury of time to allow nature to take its course.

Do you realize that people as a whole are LIVING LONGER AND HEALTHIER WITHOUT DISABILITY THAN THEY HAVE EVER DONE IN THE HISTORY OF OUR SPECIES. HOW EXACTLY DO YOU THINK THAT HAPPENED????? hmmm

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Posted: 24 May 2009 06:33 AM   [ Ignore ]   [ # 30 ]
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dougsmith - 24 May 2009 06:21 AM

(The medical profession is nowhere near as remunerative now as it once was). That is particularly true of nurses, who are most likely the people one will spend the most time with. Some of this is simply unavoidable. Everyone is trying to cut medical costs, and that will not change.

When I first started nursing, most of my time was spent at the bedside caring for a patient who was quite likely to be very ill. Now days, thanks to JACHO and other state and insurance bureaucracies, I spend a good half of my 8 hour shifts fill out paperwork to make sure I dot all of the idiotic i[i/] and cross every t. My ancillary paperwork has MORE than doubled and I shudder to think what the doctors deal with. This can’t help but compromise our patient care, and our patient load remains unchanged.(one day I will count out the number of forms I have to fill out to admit a patient and report back to you)

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